A Gap Analysis of Deep Brain Stimulation for Childhood‐Onset Movement Disorders
Daniela Munoz‐Chesta, Carolina Gorodetsky, Todd M. Herrington, Angela L. Hewitt, Daniel E. Lumsden, Jennifer O'Malley, Terence SangerAbstract
Background
Deep brain stimulation (DBS) is an established and increasingly utilized therapy for childhood‐onset movement disorders. However, pediatric DBS poses unique challenges that are not adequately addressed by adult‐derived paradigms.
Objective
To identify key gaps in the current use of DBS in childhood‐onset movement disorders and to highlight emerging pediatric‐specific strategies across the care pathway, including patient selection, targeting, surgical approaches, programming, and outcome assessment.
Methods
This educational review represents the opinions of seven clinicians and clinical researchers with extensive experience in pediatric DBS and was informed by a focused literature review of key domains identified by the authors as current gaps in the field.
Conclusions
Despite substantial progress, important gaps persist across multiple domains of pediatric DBS, including the lack of standardized, pediatric‐specific selection frameworks, limited biomarkers to guide therapy, challenges in defining meaningful outcomes, and significant global disparities in access. Emerging approaches, including individualized and genotype‐informed strategies, advances in neuromodulation technology, and international collaboration, offer potential pathways to address these limitations. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.